Introduction
Adverse childhood experiences are linked to deleterious outcomes in adulthood. Certain
populations have been shown to be more vulnerable to adversity in childhood than others.
Despite these findings, research in this area lacks an empirical investigation that
examines adverse childhood experiences among American Indian and Alaska Native populations
using large, nationally representative data. As such, the authors have compiled what
they believe is the largest empirical investigation of adverse childhood experiences
among American Indian and Alaska Native individuals to date.
Methods
Data were collected from the Behavioral Risk Factor Surveillance System from 34 states
(2009–2017), whereby all individuals self-report as American Indian and Alaska Native
(N=3,894). Adverse childhood experience scores were calculated and further stratified
by sex, age, household income, education, employment status, sexual orientation, Census
region, and state. In addition, frequencies and prevalence of each adverse childhood
experience domain (stratified by the same categories) were calculated. Analysis was
conducted in 2019.
Results
The average adverse childhood experience score among American Indians and Alaska Natives
was 2.32, higher than those of individuals identifying as White (1.53), Black (1.66),
and Hispanic (1.63). Female participants had a higher average adverse childhood experience
score than male participants (2.52 vs 2.12). Generally, younger individuals and those
with lower incomes reported higher adverse childhood experience scores, whereas those
with higher educational attainment reported lower scores.
Conclusions
Compared with the few studies among American Indian and Alaska Native populations
that have used either smaller samples or nontraditional adverse childhood experience
data (i.e., asking parents about their children's experiences), these results present
overall higher adverse childhood experience averages than previously published studies.
Nevertheless, aligning with other research on adverse childhood experiences, female
individuals, younger adults, and sexual minorities reported higher adverse childhood
experiences scores than other categories in their respective demographics.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Preventive MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
- Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the Adverse Childhood Experiences Study.JAMA. 2001; 286: 3089-3096
- Adverse childhood experiences and health outcomes in adults: the Ace study.J Fam Consum Sci. 1998; 90: 31
- Adverse childhood experiences and adult risk factors for age-related disease: depression, inflammation, and clustering of metabolic risk markers.Arch Pediatr Adolesc Med. 2009; 163: 1135-1143
- Examination of the factorial structure of adverse childhood experiences and recommendations for three subscale scores.Psychol Violence. 2014; 4: 432-444
- Adverse childhood experiences and self-reported liver disease: new insights into the causal pathway.Arch Intern Med. 2003; 163: 1949-1956
- Adverse childhood experiences are associated with the risk of lung cancer: a prospective cohort study [published correction appears in BMC Public Health. 2010;10:311].BMC Public Health. 2010; 10: 20
- Adverse childhood experiences and chronic obstructive pulmonary disease in adults.Am J Prev Med. 2008; 34: 396-403
- Insights into causal pathways for ischemic heart disease: Adverse Childhood Experiences Study.Circulation. 2004; 110: 1761-1766
- Adverse childhood experiences and the risk of depressive disorders in adulthood.J Affect Disord. 2004; 82: 217-225
- Adverse childhood experiences in relation to mood and anxiety disorders in a population-based sample of active military personnel.Psychol Med. 2013; 43: 73-84
- Correlates of adverse childhood experiences among adults with severe mood disorders.Psychiatr Serv. 2008; 59: 1018-1026
- Mortality in the United States, 2017.NCHS Data Brief. 2018; : 1-8
- Prevalence of adverse childhood experiences from the 2011‒2014 Behavioral Risk Factor Surveillance System in 23 states. [published correction appears in JAMA Pediatr. 2018;172(11):1104].JAMA Pediatr. 2018; 172: 1038-1044
- Adverse childhood experiences and mental health in young adults: a longitudinal survey.BMC Public Health. 2007; 7: 30
- The American Indian holocaust: healing historical unresolved grief.Am Indian Alsk Native Ment Health Res. 1998; 8: 56-78
- Cultural Trauma and Collective Identity.University of California Press, Berkeley, CA2004
- Historical trauma as public narrative: a conceptual review of how history impacts present-day health.Soc Sci Med. 2014; 106: 128-136
- American Indian health disparities: psychosocial influences.Soc Personal Psychol Compass. 2015; 9: 567-579
- Disparities in health, health care access, and life experience between American Indian and White adults in South Dakota.J Racial Ethn Health Disparities. 2016; 3: 301-308
- Adverse childhood experiences (ACE) among American Indians in South Dakota and associations with mental health conditions, alcohol use, and smoking.J Health Care Poor Underserved. 2017; 28: 1559-1577
- Risk and protective factors for depressive symptoms among American Indian older adults: adverse childhood experiences and social support.Aging Ment Health. 2015; 19: 371-380
- Adverse childhood experiences among American Indian/Alaska native children: the 2011‒2012 National Survey of Children's Health.Scientifica (Cairo). 2016; 20167424239
- Disentangling over-representation of parents with disabilities in the child welfare system: exploring child maltreatment risk factors of parents with disabilities.Child Youth Serv Rev. 2014; 47: 283-290
- Maternal use of physical punishment in response to child misbehavior: implications for child abuse prevention.Child Abuse Negl. 2005; 29: 169-185
- Adverse childhood experiences and multidimensional perfectionism in young adults.Pers Individ Dif. 2019; 146: 53-57
- The BRFSS data user guide.Centers for Disease Control and Prevention, Atlanta, GA2013https://www.cdc.gov/brfss/data_documentation/pdf/userguidejune2013.pdf(Published August 15)Date accessed: September 16, 2020
- Vital signs: estimated proportion of adult health problems attributable to adverse childhood experiences and implications for prevention—25 states, 2015–2017.MMWR Morb Mortal Wkly Rep. 2019; 68: 999-1005
- Capitalizing on advances in science to reduce the health consequences of early childhood adversity.JAMA Pediatr. 2016; 170: 1003-1007
- Behavioral Risk Factor Surveillance System questionnaire.Centers for Disease Control and Prevention, Atlanta, GA2016https://www.cdc.gov/brfss/questionnaires/pdf-ques/2016_brfss_questionnaire_final.pdf(Published October 14, 2015)Date accessed: September 16, 2020
- Fourth national incidence study of child abuse and neglect (NIS-4): report to Congress.HHS, Administration for Children and Families, Washington, DCPublished 2010https://www.acf.hhs.gov/sites/default/files/opre/nis4_report_congress_full_pdf_jan2010.pdfDate accessed: September 16, 2020
- Disparities in adverse childhood experiences among sexual minority and heterosexual adults: results from a multi-state probability-based sample.PloS One. 2013; 8: e54691
- The relationship of adverse childhood experiences to PTSD, depression, poly-drug use and suicide attempt in reservation-based Native American adolescents and young adults.Am J Community Psychol. 2015; 55: 411-421
- Preventing adverse childhood experiences: leveraging the best available evidence.National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GAPublished 2019https://www.cdc.gov/violenceprevention/pdf/preventingACES.pdfDate accessed: September 16, 2020
- Family-centered prevention ameliorates the association between adverse childhood experiences and prediabetes status in young black adults.Prev Med. 2017; 100: 117-122
- Preventing and mitigating the effects of ACEs by building community capacity and resilience: APPI cross-site evaluation findings (final report).Mathematica Policy Research, Washington, DC2016https://www.mathematica.org/our-publications-and-findings/publications/final-report-preventing-and-mitigating-the-effects-of-aces-by-building-community-capacity(Published July 14)Date accessed: September 16, 2020
- Wicasa Was'aka: restoring the traditional strength of American Indian boys and men.Am J Public Health. 2012; 102: S177-S183
- Sensitive questions in surveys.Psychol Bull. 2007; 133: 859-883
- Validity of adult retrospective reports of adverse childhood experiences: review of the evidence.J Child Psychol Psychiatry. 2004; 45: 260-273
Federal and state recognized tribes. National Conference of State Legislatures.https://www.ncsl.org/research/state-tribal-institute/list-of-federal-and-state-recognized-tribes.aspx#State. Updated March 2020. Accessed September 16, 2020.
- Historical trauma in American Indian/Native Alaska communities: a multilevel framework for exploring impacts onindividuals, families, and communities.J Interpers Violence. 2008; 23: 316-338
Article Info
Publication History
Published online: November 20, 2020
Identification
Copyright
© 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
